RecruitingPhase 2NCT06620835

Trial for Local Ablative Treatment (LAT) Optimization in Patients With Advanced Non-Small Cells Lung Cancer (NSCLC) Presenting an Anaplastic Lymphoma Kinase (ALK) Rearrangement Treated by Brigatinib

Optimization of Treatment With Brigatinib in Patients With Advanced NSCLC Harboring an ALK Rearrangement by LAT at the Time of Best Response: A Multicenter Open Phase Two Trial (OPTALK)


Sponsor

Groupe Francais De Pneumo-Cancerologie

Enrollment

45 participants

Start Date

Jun 19, 2025

Study Type

INTERVENTIONAL

Conditions

Summary

The goal of this clinical trial is to learn if the treatment by systemic Brigatinib (ALUNBRIG®) associated to local ablative therapy (LAT) treatment is improved if administered when the brigatinib works best in participants presenting an advanced non-small cells lung cancer with an ALK gene anomaly (this anomaly produces a defective protein that is responsible for the multiplication of cancer cells). This clinical trial is expected to involve 45 participants in several sites in France. Advanced non-small cell lung cancer (NSCLC) participants with ALK rearrangements treated with brigatinib in first line of non-curable setting will be screened. If the disease assessment done between 3 to 9 months after initiation of brigatinib shows: * a tumor response or stabilization (according to RECIST 1.1) * a disease which meets the definition of an oligometastatic disease (five metastatic lesions or less and a maximum of two lesions per organ) * all tumor targets are accessible to a local ablative therapy (confirmed by an expert panel of clinicians before inclusion): surgery, stereotactic radiosurgery (SRS). For liver, adrenal, or other metastases, percutaneous thermal ablation will be accepted. Participants will be asked to visit the clinic: * for eligibility criteria assessment prior to LAT * for LAT * every 8 weeks for checkups and tests the first year after LAT * and then every 12 weeks, for a maximum period of 3 years. Eligible patients will benefit from local ablative therapy with continuation of brigatinib.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study is for people with advanced non-small cell lung cancer (NSCLC) that has a specific genetic change called an ALK rearrangement. Participants are already responding to a targeted drug called brigatinib. The study tests whether adding focused local treatments (like radiation or ablation) to remaining tumor spots — on top of the targeted drug — can help keep the cancer controlled longer. **You may be eligible if...** - You are 18 or older - You have stage 3 (not eligible for chemoradiation) or stage 4 NSCLC with an ALK gene rearrangement - You have been on brigatinib for 3–9 months and your cancer is stable or responding - You still have at least one measurable tumor remaining - You have 5 or fewer total tumor spots (and no more than 2 in any single organ) - You have not previously received targeted therapy (TKI) for this cancer **You may NOT be eligible if...** - Your cancer has completely disappeared on treatment (complete response) - You have more than 5 metastatic sites or more than 2 organs involved beyond oligometastatic limits Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

BIOLOGICALBlood samples for Hematology

Complete blood count will include erythrocytes, neutrophils, eosinophils, basophils, lymphocytes, monocytes, platelets, leukocytes, hemoglobin, hematocrit.

BIOLOGICALBlood samples for Chemistry

Clinical chemistry will include serum electrolytes (sodium, potassium, calcium, corrected calcium for hypoalbuminemia), creatinine, CrCl with local formula, and fasting blood glucose.

BIOLOGICALBlood sample for liver function tests

Laboratory tests to assess liver function will include Aminotransferase Alanine (ALAT), Aminotransferase Aspartate (ASAT), Phosphatase Alkaline (ALP), Gamma-glutamyl Transferase (GGT), total and conjugated bilirubin.

BIOLOGICALPregnancy test

Pregnancy test will be performed in women of childbearing potential, including women who have had a tubal ligation. Childbearing potential is defined as not having undergone surgical sterilization, hysterectomy, and/or bilateral oophorectomy or not being postmenopausal (≥12 months of amenorrhea). Urine pregnancy tests will be based on the measurement of β-Human Chorionic Gonadotropin (HCG). If a urine pregnancy test is positive, it must be confirmed by a serum pregnancy test. Urine pregnancy tests will be performed at screening.

PROCEDURETumour assessment

Tumor assessment according to the RECIST v1.1 include the following radiological evaluation: thoracic CT scan, brain MRI or CT scan (MRI is preferred), abdominopelvic scan, PET-CT scan mandatory and at the Investigator's discretion, if needed bone scintigraphy and chest X-ray.

PROCEDURELocal Ablative Therapy (LAT)

Local Ablative Treatment (LAT) (stereotactic body radiotherapy, surgery, thermal ablation)


Locations(27)

CHU de Brest

Brest, France

Centre François Baclesse

Caen, France

CH Métropole-Savoie

Chambéry, France

Hôpital Louis Pasteur

Colmar, France

Pneumologie Centre Hospitalier Intercommunal de Créteil

Créteil, France

Centre Georges-François Leclerc

Dijon, France

CH Annecy

Épagny, France

Polyclinique de Blois

La Chaussée-Saint-Victor, France

CHD les Oudaries

La Roche-sur-Yon, France

CHU Dupuytren

Limoges, France

Centre Leon Bérard

Lyon, France

Hôpital Nord

Marseille, France

CHRU de Nancy

Nancy, France

CLCC Antoine Lacassagne

Nice, France

CHU de Nîmes

Nîmes, France

CHU Orléans

Orléans, France

Hôpital Tenon

Paris, France

CHU de Bordeaux Haut Lévêque

Pessac, France

CHU Rennes, Hôpital Pontchaillou

Rennes, France

CHU Ponchailloux

Rennes, France

Hôpital Charles Nicolle

Rouen, France

Pneumologie CHU St Etienne

Saint-Etienne, France

CHU de la Réunion

Saint-Pierre, France

Centre Paul Strauss

Strasbourg, France

HIA St Anne

Toulon, France

CH Bretagne Atlantique

Vannes, France

Centre Hospitalier de Villefranche sur Saone

Villefranche-sur-Saône, France

View Full Details on ClinicalTrials.gov

For the most up-to-date information, visit the official listing.

Visit

NCT06620835


Related Trials